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How AI Is Revolutionizing Healthcare

Great strides are being made by AI in the healthcare sector. The AI market in healthcare is due to increase tenfold by 2025, becoming a $13 billion industry, according to Global Market Insights. But currently, advances are generally tied to frontline medicine, rather than back-office administrative and finance functions. “Most of the machine learning and artificial intelligence gains we’re seeing right now are on the clinical and diagnostic sides,” explains Brian Sanderson, National Managing Principal of Healthcare Services at the accounting, consulting and technology firm Crowe.

But there’s a value opportunity to be gained from harnessing machine learning and AI beyond the bedside, too. It’s one that can help hospitals save money on administration and allow health system leadership to focus more on what should be at the core of everything they do: keeping people healthy. While the revolution is well underway in frontline medicine, hospital administrators are just beginning to recognize the power and applications of AI. Here, explore three areas of back-office healthcare where the chance for revolution, aided by AI, is ripe: exceptions management, hospital administration and revenue cycle operations.

1. Exceptions Management: Reducing Errors All Around

For decades, hospital business office personnel have been attempting to recognize, resolve and prevent billing exceptions, i.e. claims that did not smoothly complete the payment cycle. But with machine learning and AI, it’s possible to put actual computing power to work spotting patterns that even the most skilled humans cannot.

Working with a large health system, Crowe used AI to analyze a large health system’s credit balances — patient accounts that did not resolve to zero. “They had anomalies, and they had exceptions,” says Sanderson. “There shouldn’t be any if your manufacturing process is running correctly.” The system had 17 people working on resolving and processing credit exceptions.

As soon as Crowe put AI on the case, it discovered that a single compliance issue was occurring thousands of times per month. “We found 16,000 of them by using AI, and were able to turn it off and fix it,” says Sanderson. “Suddenly 16,000 exceptions stop coming.”

“Cost-driven automation,” as Sanderson calls it, is a transformative innovation for the healthcare space.

2. Administration: Keeping Hospital Operations From Flatlining

Current C-suite staff focused on finance are tasked with juggling plenty of plates. The chief financial officer (CFO) keeps an eye on revenues, while the chief operating officer (COO) has to look at the bottom line and keep costs low. But aided by AI, the CFO can oversee both sides of the equation with ease, freeing up the COO to keep services running smoothly on a day-to-day basis. This kind of leadership and staffing efficiency is essential because hospitals are always at risk of taking their eye off the main goal: keeping people healthy and ensuring that the day-to-day operation of healthcare systems runs smoothly.

The AI revolution will involve feeding in and parsing data from entire specialty wings and specific beds within a hospital or hospital group to better allocate resources automatically, Sanderson believes. “I think you will be able to look at the trends and diagnoses that are within the four walls of your hospital and be able to use that as an operational managerial tool,” he says. “You’ll be able to determine what your labor needs are, your food supplies and your medications” — all with better precision than ever before.

This is just around the corner, he notes, and is likely to manifest in the next few years. “It’s about as hot as it can be right now, with respect to interest and applicability,” he says of the AI buzz in hospital finance. Crowe, for one, is using technology that helps CFOs at its client organizations get a better handle on what financial position they’ll finish the year in. That use of technology is likely to expand in the near future, using information at present (including its current financials, sickness levels and hospital performance) and broader trends in the industry to project what a healthcare company’s financial performance will be in the future.

Better prediction and projection can help health systems take better risks, too, says Sanderson. Bolstered by big data, hospitals know when to take the plunge on investing several million in a new wing or diagnostic machine, for example, and when they’ll need to funnel all resources into keeping pace with more immediate concerns. “It can incorporate things like what happens when flu season hits, if there are implications from weather or if competitors open up particular facilities.”

3. Revenue Cycles: It’s a Journey To Automation

“Every health system has to become more efficient to reduce costs,” explains Sanderson. It’s a simple fact of business. But to truly bolster the revenue cycle, health systems must follow a multi-stage journey to reach maximum efficiency, according to Crowe. The first step in the process is to recognize people and processes that set the standard for optimal operations.

The second is to standardize processes to mimic highest achievers: encourage everyone to follow the path that one high achiever takes. “A lot of consulting sort of stops there,” says Sanderson: “‘This is the way you should be doing it; we want everybody doing it this way.’” But taking it a step further — and systematizing your processes — can unlock even greater efficiency. Utilizing the appropriate technology, either by ensuring the effective use of systems already in place or investing in technology that enables your teams to complete, and repeat, the correct process, is essential. Enhancing standardized human workers by giving them access to AI tools and big data helps compel them to work smarter. However, it’s still not the most efficient method of handling the revenue cycle. That comes with automation: utilizing AI across organizations to determine the best industry practice and delegating redundant tasks to machines through RPA, thus freeing up human workers to take on more uniquely human problems and relying on fewer staff to monitor machine performance.

“Where are most [organizations] on that spectrum?” asks Sanderson. “Most are somewhere in the middle of that journey.” Progress is linear and must incorporate every step, he says. It’s not possible to skip straight to automation, since the processes in place and being automated might incorporate glitches.

But as more health systems progress further along that journey, feeding more data into the bigger picture, the benefits become greater too. Crowe currently has access to 1,200 hospitals’ data, across a wide geographic span, and is leveraging that to improve performance across the board. It allows the company to take in the entire scope of current innovation — and help clients learn from best practices and peers. “The future is an amalgamation of data to allow for the best of the best,” says Sanderson. “The idea is to take an entire industry worth of data and build something scalable, and adoptable, for the industry.” In so doing, healthcare organizations allow their professionals to focus on the real goal: keeping people healthy and providing better care for all.

Crowe Contributor Crowe Contributor Brand Contributor

Crowe LLP is a public accounting, consulting, and technology firm with offices around the world.

Source: How AI Is Revolutionizing Healthcare

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72 People Ill From E. Coli Outbreak, What Is The Cause?

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Pictured here is one strain of Shiga toxin-producing Escherichia coli. (Photo: Getty Images)

Oh 103, no. Today, the Centers for Disease Control and Prevention (CDC) announced that at least 72 people in 5 states have already gotten sick from an outbreak of Shiga toxin-producing Escherichia coli (E. coli) O103. Therefore, for now, be careful when eating anything. Anything? Yes, anything.

That’s because so far there is no clear cause of the outbreak that has affected at least 8 people in Georgia, 36 people in Kentucky, 5 in Ohio, 21 in Tennessee, and 2 in Virginia and has resulted in at least 8 hospitalizations.  A timeline provided by the CDC shows that illnesses started on March 2 , 2019. Those affected have ranged in age from one year old to 74 years young. The median age of people who have gotten ill is 17 years.

I’ve already written for Forbes about another STEC, Shiga toxin-producing E. coli, that goes by the name O157:H7. This agent, not to be confused with 007, was the cause of the outbreak that was eventually linked to Romaine lettuce last year. A STEC by any name is not good. Besides causing all kinds of poop, including bloody poop, that starts 2 to 8 days after entering your mouth, a STEC can, in some cases, be life threatening.

The biggest concern is hemolytic uremic syndrome (HUS). As I have described before, this is HUS and it’s not good: the Shiga toxin triggers destruction of your red blood cells, which can then result in pieces of red blood cells clogging up your kidneys, your kidneys potentially failing, and you potentially dying. The typical symptoms of an “uncomplicated” STEC infection are bad stomach cramps, vomiting, and bloody diarrhea. You should worry about HUS if you develop a fever, a pale skin tone, fatigue and irritability, small, unexplained bruises or bleeding from the nose and mouth, and especially decreased urination.

STEC can be all kinds of different foods and beverages. The Foodsafety.gov website includes the following examples:

  • Contaminated food, especially undercooked ground beef, unpasteurized (raw) milk and juice, soft cheeses made from raw milk, and raw fruits and vegetables (such as sprouts)
  • Contaminated water, including drinking untreated water and swimming in contaminated water
  • Animals and their environment: particularly cows, sheep, and goats. If you don’t wash your hands carefully after touching an animal or its environment, you could get an E. coli infection
  • Feces of infected people

So take precautions when potentially eating or drinking anything, including the feces of other people. I know, I know, you say that feces is not part of your diet. But you would be surprised by how much poop gets around if you don’t wash your hands. So wash your feces-ed hands, frequently and thoroughly, especially when handling food or your mouth.

Here’s how:

Besides washing your hands, which you should do frequently and thoroughly, the CDC recommends that you cook meats thoroughly (steaks and roasts to at least 145˚F and ground beef and pork to at least 160˚F), thoroughly clean anything that touches raw meat, wash fruits and vegetables before eating them, and avoid raw dairy products and unpasteurized juices. Oh, and you should wash your hands, thoroughly and frequently.

For now, the CDC and other authorities are searching for a source of this latest STEC outbreak. Therefore, wait for updates and wash your hands, thoroughly and frequently. The aforementioned food safety recommendations should apply regardless of whether there is a STEC outbreak. In other words, don’t return to wearing raw meat masks, guzzling raw milk, licking cutting boards clean, using unwashed celery as floss, and not washing your hands, frequently and thoroughly after an outbreak has passed.

Follow me on Twitter @bruce_y_lee and visit our Global Obesity Prevention Center (GOPC) at the Johns Hopkins Bloomberg School of Public Health. Read my other Forbes pieces here

My career has spanned the worlds of digital and computational health, business, academia, medicine, global health, and writing. Currently, I am the Executive Director of..

Source: 72 People Ill From E. Coli Outbreak, What Is The Cause?

53% of Small Business Owners Worry Over Cost of Healthcare – Michael Guta

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A recent survey of America’s small business owners suggests more than half or 53% count the cost of providing healthcare insurance for their employees as a key concern.

Worried About the Cost of Small Business Health Insurance

Healthcare costs eat up a huge chunk of the small business operation budget. According to the NFIB’s Index of Small Business Optimism, the biggest challenge for small business owners is healthcare. And the eHealth report, Small Business Health Insurance: Costs, Trends and Insights 2017 indicates close to 80% of small business owners worry about the cost.

While in most cases small business owners operate locally, developments outside their region and other macro trends may also have an impact. These issues include everything from higher healthcare costs to taxes and regulations which affect day to day operations.

In the press release announcing the SmallBiz Loans survey, company CEO Evan Singer points out how these trends affect owners. Singer explains, “The survey illustrates that small business owners are aware of macro trends that may impact their business. But their focus is instead on the day-to-day functions of running their company. And the great news is that the new tax plan is helping to drive immediate growth.”

The new tax plan is important to many small business owners too. According to the survey, 52% of respondents gave changes in the new tax law as a key business consideration. The new tax law has been cited by 35% of business owners as a driver for making changes in their operations, with 10% reporting they are making additional investments in new staff and equipment.

But challenges in recruiting talent also rate high. In this time of low unemployment, finding talent is becoming a big problem for businesses of all sizes. In the survey, 49% of business owners reported finding and hiring quality employees is a top concern. And when it comes to hiring new talent, for nine out of 10 of the respondents experience is more of a priority than education.

As it becomes harder to find qualified employees, 31% of respondents to the survey said they are willing to hire candidates with fewer qualifications and train them. At the same time, small businesses are providing more incentives, with 51% of owners offering flexible working arrangements and another 33% higher wages.

Regarding how small business owners feel about the economy, close to 57% of owners said they remain bullish, stating their outlook over the next 12 months was fairly positive or positive. And as some businesses look to grow, they will require funding.

Funding was another key issue touched upon. Securing this funding is getting easier according to 22% of respondents. But getting this capital has become more expensive, with 49% saying they agree or strongly agree the price of credit has gone up.

The survey was carried out from April 9 through April 17, 2018, with the participation of 289 small business owners across the United States. They were questioned on several subjects including financing, growth plans for the year, hiring, talent, and concern for their businesses.

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